Improving the participation of the cardiac surgery patient through nursing rounds

Abstract Introduction The traditional medical round alone is not enough to cover the needs of the cardiac surgery patient with a complex care pathway. There is no time to care for these patients in an evidence-based and structured way. Patient participation is also low in this patient group. The improvement project had two aims: to increase the involvement for this patient group and to introduce evidence-based nursing diagnoses, goals and measures by introducing nursing rounds. The improvement work was conducted at the cardiac surgery ward at Karolinska University hospital. Method An impact analysis, Nolan's improvement model and PDSA wheel was used and an approach to introducing, and testing nursing rounds was designed. Data was collected through interviews with patients and chart reviews. The study of the improvement project was qualitative with an inductive approach to investigate the factors that influence the sustainability of nursing rounds as an established practice. Focus group interviews were conducted with seven nursing staff who had participated in a nursing round. The data was analysed using reflexive thematic analysis. Result The results show that patients who participate in nursing rounds estimate their participation slightly higher than patients who did not participate Evidence-based nursing diagnoses, goals and interventions were introduced for this patient group. There are conditions for a sustainable approach, but there are also factors that can hinder sustainability. Discussion More person-centered measures than nursing rounds are needed to increase patient participation. The nursing staff is positively disposed to nursing rounds, that support and allocated time for nursing rounds is crucial.